In May 2013 I asked my GP to put me on Duloxetine (alongside my 20mg Amitriptyline), as she refused to send me to pain clinic. However after an initial 3 week "rush" I slumped into really bad fatigue. After 6 months I moved over to Fluoxetine, as I suspected the adrenalin levels in my body had been upset by the duloxetine. After a short remission, it started up again, so I reckoned that because the Amitriptyline has the same mechanism - and I have been on it over 11 years - I would try coming off that slowly. I took my last one last week, and I still feel rough.

I am going through the menopause, but this is extremely bad. My sleep is being affected and I am getting really hot spells at work, where I have to stop and sit down and get a cold drink. I work at a hospital, and have had numerous staff tell me I look rough and shouldn't be that bad just coming off 20mg dose.

Has anyone else had this problem which could have been set off by Duloxetine? Can it cause adrenal fatigue, and how long do you think it will take before I know the Amitripyline will be out of my system totally?

I am going through getting a referral to the sleep clinic - hence another reason I am off the Ami, as I was told previously it would be necessary before they could get an accurate test, but never dared come off them before.

10 Replies

Can I ask if you are withdrawing with the knowledge of your GP ? It is very important not to take oneself off any medication without the backup of their GP as it is easy to run into problems especially if you have withdrawn quite quickly.

I mentioned it to the GP on my last visit, and she seemed unphased by it, but I have been weaned off it onto gabapentin and back again and up and down my dose under doctors there only to find some of it not documented when I looked through my notes. So whether or not it registered with her is anyones guess

I have an appt in a couple of weeks so will check with them then that there has been a note made or not..

I am so sorry to read that you are experiencing this issue and I genuinely hope that you can find the answers that you so desperately desire and deserve. I have pasted you an NHS Choices link to Adrenal Fatigue, so I hope that you find it useful:

Perhaps this is a stupid question but why has your GP refused to refer you to a Pain Management Clinic when you're obviously in quite a lot of pain? Is it possible to self-refer?

Even with the Adrenal fatigue, you shouldn't be reacting so much to Amitriptyline withdrawal. I also had to come off it for one month to attend a sleep clinic where I was diagnosed with severe sleep apnea and although I struggled with insomnia and sleepiness, I wouldn't say my condition was worsened. I'm actually not sure how effective the duloxetine has been for me although I'm reluctant to change it to pregabalin or gabapentin - both of which gave me some unpleasant side effects.

You mention the effects of your menopause. To be honest, I can relate to your symptoms and think I've been menopausal for the last five years. The problem with having multiple conditions is that it's often difficult to isolate which symptom relates to which condition etc.

My advice is, if in doubt, consult. Head back to your GP, describe in detail how you're feeling and make suggestions that could potentially be ruled out but at least, discussed and investigated if necessary. Believe me, things do get better once the menopause symptoms calm down.

Wishing you all the best at the sleep clinic - hope it's nothing too serious. Let us know how you get on.

I originally asked the GP if I could try the pain clinic and she told me it had closed. I work at the hospital so knew that was wrong, so I told her I would find someone to refer me to for her, and she initially agreed. When I found someone she then backtracked and told me that there was nothing the Pain Clinic could do that the GP couldn't.....

Some of it I know will be down to the menopause, and the hormones, as the only remission I had was just before I had a really heavy period last year brought on by a uterine polyp. Two months later back to square one again (and this was before the removal of the polyp, so the jury is still out as to whether the polyp was the cause)

The sleep clinic was recommended by the chronic fatigue clinic. The GPs again were stalling on sending me to the Sleep clinic, but luckily after a dodgy blood test and seeing my BMI and sleep score the CFS clinic saw sense and told the GP to send me there.

I still have to get the GP to refer me, so heres hoping. If not I am changing the surgery...promptly!